Verapamil: functions, dosage, side effects, how to use it

What medicine is Verapamil?

What is Verapamil for?

Verapamil is a drug with a function to treat high blood pressure (hypertension). Verapamil can be used with or without other drugs. Lowering high blood pressure can prevent strokes, heart attacks, and kidney problems. Verapamil is known as a calcium channel blocker. This drug works by relaxing the blood vessels so that blood can flow more easily.

Verapamil is also used to prevent chest pain (angina). Helps improve your ability to exercise and reduce the frequency with which you get angina attacks. Verapamil can also be used to control your heart rate, if you have a fast or irregular heartbeat (such as atrial fibrillation). This medication can help slow down your heart rate, make you feel more comfortable and improve your ability when you exercise.

OTHER USES: This section lists uses for this drug that are not listed on approved labels, but may be prescribed by your healthcare professional. Use this medication for the conditions listed below only if it has been prescribed by your doctor and health care professional.

This drug can be used to treat other heart diseases (hypertrophic cardiomyopathy).

The verapamil dosage and the side effects of verapamil are detailed below.

How do I use Verapamil?

Follow the rules given by your doctor or pharmacist before starting treatment. If you have any questions, consult your doctor or pharmacist.

Take this medication after or before meals, usually 3 to 4 times a day as directed by your doctor.

The dosage is always given based on your health condition and how you respond to therapy.

Use this remedy regularly for best results. To help you remember, drink it at the same time each day.

For the treatment of high blood pressure, it may take about a week for you to really feel the benefits of this medication. It is important that you continue to take the medication even if you feel well. Most people with high blood pressure do not feel pain in themselves.

To prevent chest pain, it is very important to take medication regularly as prescribed. Do not use this medication while chest pain is in progress. Use other medications to relieve seizures as directed by your doctor (for example, nitroglycerin tablets, put under your tongue). Consult your doctor or pharmacist for more.

Stopping doses too early without your doctor's approval risks the risk of worsening your health condition. Your doctor will gradually lower your prescription for your medicines.

If your health condition does not improve (your blood pressure remains high or increases every day, or the frequency of chest pain becomes more frequent), consult your doctor or pharmacist.

How to save Verapamil?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Verapamil dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dosage for Verapamil for adults?

Oral:

The antihypertensive effect of verapamil was evident in the first week of treatment.

Immediate release tablets (Calan (R)):

Initial dose: 80 mg 3 times a day; alternatively, 40 mg 3 times a day may be considered for patients who can respond to a lower dose (e.g. petite).

Maintenance dose: The increment of the titration should be based on the success of the therapy, which is assessed at the end of the dosing interval. A daily dose of 360 to 480 mg can be used but there is no evidence that doses exceeding 360 mg increase the effect.

Sustained release tablets (Calan SR (R), Isoptin SR (R)):

Initial dose: 180 mg once daily in the morning after meals: alternatively, 120 mg once daily in the morning after meals can be given to patients who have an increase in verapamil (eg petite).

Maintenance dose: Titration increment should be based on therapeutic success and weekly evaluation, approximately 24 hours after the previous dose administration. If an adequate response is not obtained with the initial dose, then the possibility of titration can be increased.

Sustained release capsules (Verelan (R)):

Initial dose: 240 mg once a day in the morning (standard dose in clinical trials); alternatively, 120 mg once a day in the morning may be allowed for patients who have an increased response to verapamil (e.g. petite).

Maintenance dose: Titration increment should be based on the success of therapy and weekly evaluation approximately 24 hours after dosing. If an adequate response is not obtained at the initial dose, then the possibility of titration can be increased.

Extended release tablets (Covera HS (R)):

Initial dose: 180 mg once a day before bed.

Maintenance dose: If an adequate response is not obtained, the titration may be increased.

Extended release capsules (Verelan PM (R)):

Initial dose: 200 mg once a day before bed (standard dose in clinical trials); in rare cases, an initial dose of 100 mg once daily at bedtime may be allowed in patients who have an increased response to verapamil (eg, patients with low body weight).

Maintenance dose: Titration increment should be based on the success of therapy and evaluation approximately 24 hours after dosing. If an adequate response is not obtained at the initial dose, the titration may be increased.

What is the dosage of Verapamil for children?

IV:

<1 year old:

Generally not recommended because of the potential for severe apnea, bradycardia, hypotensive reactions, and heart attacks; IV calcium should be available at the bedside

Initial dose: 0.1 to 0.2 mg / kg / dose (single dose range: 0.75 to 2 mg / dose) should be given as an IV bolus for at least 2 minutes under continuous ECG surveillance.

Maintenance dose: 0.1 to 0.2 mg / kg / dose (single dose range: 0.75 to 2 mg / dose) 30 minutes after first dose administration if initial response is inadequate (under ECG follow-up monitoring)

The optimal distance for the next dose has not been determined and must be based on the circumstances of each individual patient.

1 to 15 years:

Initial dose: 0.1 to 0.3 mg / kg / dose (single dose range: 2 to 5 mg / dose) should be given as an IV bolus for at least 2 minutes; the dose should not exceed 5 mg.

Maintenance dose: 0.1 to 0.3 mg / kg / dose (single dose range: 2 to 5 mg / dose) 30 minutes after administration of the first dose if the previous response is inadequate; the dose should not be more than 10 mg.

The optimal distance for the next dose has not been determined and must be based on the circumstances of each individual patient.

In what dosage is Verapamil available?

• Tablets: 180 mg; 240 mg
• Injection

Verapamil side effects

What side effects can be experienced due to Verapamil?

Seek medical help right away if you experience an allergic reaction: hives; difficulty breathing; swelling of the face, lips, tongue, or throat.

Tell your doctor right away if you experience serious side effects, such as:

• Fast or slow heart rate
• Feelings like you might pass out
• Fever, sore throat, and severe headache, and there is a red rash on the skin
• Restless movements of the eye, tongue, jaw or neck muscles
• Feeling short of breath, even though you don't move much
• Swelling, rapid weight gain
• Nausea, stomach pain, fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin and eyes)

Less serious side effects include:

• Constipation, nausea
• Rash on the skin or itching
• Dizziness, headache, tired feeling; or
• Chills, itching, redness, or a tingling feeling under your skin

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Verapamil Drug Warnings and Cautions

What should be known before using Verapamil?

Before using certain drugs, consider the risks and benefits first. This is a decision you and your doctor will have to make. For this drug, pay attention to the following:

Allergy

Tell your doctor if you have any unusual or allergic reactions to this or any other medicine. Also tell your doctor if you have any other types of allergies such as to food, coloring, preservatives, or animal allergies. For over-the-counter products, read the labels on the packaging carefully.

Children

No information is available on the relationship of age to the effect of this drug in pediatric patients. Safety and efficacy have not been established.

Elderly

Although no information is available on the relationship between age and the effect of verapamil in the geriatric population, no specific problems have been found with the use of this drug in the elderly. However, elderly or elderly patients are more sensitive to the effects of medications and age-related liver, kidney, or heart problems, thus requiring dose adjustments for elderly patients on verapamil treatment.

Is Verapamil safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = Not at risk
• B = No risk in several studies
• C = Maybe risky
• D = There is positive evidence of risk
• X = Contraindicated
• N = Unknown

Verapamil Drug Interactions

What medicines may interact with Verapamil?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Although several drugs should not be used simultaneously, in other cases two different drugs may be used simultaneously even if interactions are possible. In this case, your doctor may change the dose, or other precautions may be needed. Tell your doctor if you are using any other prescription or nonprescription (over-the-counter) medication.

Using this medication with any of the following drugs is not recommended. Your doctor may decide not to treat you with this drug or change some of the medicines you have used.

• Colchicine
• Dofetilide
• Lomitapide

Using this medication with any of the following drugs is usually not recommended, but may be needed in some cases. If both drugs are prescribed together, your doctor may change the dose or the frequency with which you use one or both drugs.

• Acebutolol
• Adenosine
• Afatinib
• Alprenolol
• Amiodarone
• Apixaban
• Aripiprazole
• Atazanavir
• Atenolol
• Atorvastatin
• Betaxolol
• Bevantolol
• Bisoprolol
• Bosutinib
• Bucindolol
• Bupivacaine
• Bupivacaine Liposome
• Carbamazepine
• Carteolol
• Carvedilol
• Celiprolol
• Ceritinib
• Clarithromycin
• Clonidine
• Clopidogrel
• Clozapine
• Cobicistat
• Crizotinib
• Cyclobenzaprine
• Dabigatran Etexilate
• Dabrafenib
• Dantrolene
• Digoxin
• Dilevalol
• Domperidone
• Doxorubicin
• Doxorubicin Hydrochloride Liposome
• Dronedarone
• Eliglustat
• Eplerenone
• Erlotinib
• Erythromycin
• Eslicarbazepine Acetate
• Esmolol
• Everolimus
• Fentanyl
• Fingolimod
• Hydrocodone
• Ibrutinib
• Idelalisib
• Ifosfamide
• Ivabradine
• Ketoconazole
• Labetalol
• Lacosamide
• Levobunolol
• Lovastatin
• Lurasidone
• Mepindolol
• Mepivacaine
• Metipranolol
• Metoprolol
• Mitotane
• Morphine
• Morphine Sulfate Liposome
• Nadolol
• Naloxegol
• Nebivolol
• Nilotinib
• Nintedanib
• Oxprenolol
• Penbutolol
• Pindolol
• Piperaquine
• Pixantrone
• Primidone
• Propranolol
• Ranolazine
• Siltuximab
• Simeprevir
• Simvastatin
• Sotalol
• Talinolol
• Tertatolol
• Timolol
• Tizanidine
• Tolvaptan
• Topotecan
• Trabectedin
• Vilazodone
• Vincristine
• Vincristine Sulfate Liposome

Using this medication with one of the following drugs will increase your risk of certain side effects, but taking the two drugs together may be the best treatment for you. If both drugs are prescribed together, your doctor may change the dose or how often you use one or both drugs.

• Aceclofenac
• Acemetacin
• Amtolmetin Guacil
• Aspirin
• Bromfenac
• Bufexamac
• Buspirone
• Celecoxib
• Choline Salicylate
• Clonixin
• Cyclosporine
• Dalfopristin
• Dexibuprofen
• Dexketoprofen
• Diclofenac
• Dislunisal
• Digitoxin
• Dipyrone
• Dutasteride
• Etodolac
• Etofenamate
• Etoricoxib
• Felbinac
• Fenoprofen
• Fepradinol
• Feprazone
• Flecainide
• Floctafenine
• Flufenamic Acid
• Flurbiprofen
• Fosphenytoin
• Ibuprofen
• Ibuprofen Lysine
• Indinavir
• Indomethacin
• Itraconazole
• Ketoprofen
• Ketorolac
• Lithium
• Lornoxicam
• Loxoprofen
• Lumiracoxib
• Meclofenamate
• Mefenamic Acid
• Meloxicam
• Midazolam
• Morniflumate
• Nabumetone
• Naproxen
• Nepafenac
• Nevirapine
• Niflumic Acid
• Nimesulide
• Oxaprozin
• Oxcarbazepine
• Oxyphenbutazone
• Pancuronium
• Parecoxib
• Phenobarbital
• Phenylbutazone
• Phenytoin
• Piketoprofen
• Piroxicam
• Pranoprofen
• Proglumetacin
• Propyphenazone
• Proquazone
• Quinidine
• Quinupristin
• Rifapentine
• Ritonavir
• Rofecoxib
• Salicylic Acid
• Salsalate
• Sirolimus
• Sodium Salicylate
• St. John's Wort
• Sulindac
• Tedisamil
• Telithromycin
• Tenoxicam
• Tiaprofenic Acid
• Tolfenamic Acid
• Tolmetin
• Tubocurarine
• Valdecoxib
• Vecuronium

Can food or alcohol interact with Verapamil?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. The following interactions are selected based on their importance and are not all-inclusive.

Using this medication with any of the following lists is not recommended, but may not be avoided in some cases. When used together, your doctor may change the dose and frequency with which you take the drug, or give you specific instructions regarding use of food, alcohol, or tobacco.

• Tobacco
• Ethanol
• Grapefruit juice

What health conditions may interact with Verapamil?

Other health problems in your body can affect the use of this drug. Tell your doctor if you have other health problems, especially:

• Congestive heart failure
• Muscle disease (for example, Duchenne's muscular dystrophy, myasthenia gravis)
• Pulmonary edema (fluid in lungs) ⎯Use with caution. The condition might get worse
• Heart block (an abnormal type of heartbeat)
• Heart problems (for example, Wolff-Parkinson-White syndrome, Lown-Ganong-Levine syndrome)
• Low blood pressure (hypotension)
• Sinus syndrome (heart rate problems, can be used if you have a working pacemaker) ⎯ should not be used in patients with this condition
• Kidney problems
• Problems of caution⎯ use with care. The effects may increase due to the slow removal of the drug from the body

Verapamil overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the emergency services provider (112) or immediately to the nearest hospital emergency department.

Overdose symptoms include:

• Dizzy
• Blurred vision
• Slow, fast, or irregular heartbeat
• Seizure
• Chaotic
• Difficulty breathing or swallowing

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is near the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.